The PM’s deal with AstraZeneca is for a COVID vaccine being developed by scientists at Oxford University in the United Kingdom. He also committed to securing vaccines for Australia’s regional neighbour countries.

Over the weekend, three Australian Archbishops – Anthony Fisher, the Catholic Archbishop of Sydney, Glenn Davies of the Sydney Anglicans and the Greek Orthodox Archbishop of Australia, Makarios Griniezakis – wrote a joint-letter to Mr Morrison asking him to seek alternative COVID vaccines.

“This week’s announcement that a Letter of Intent has been signed between our government and AstraZeneca for a vaccine raises some important ethical questions because the vaccine in question makes use of a cell line cultured from an electively aborted human foetus,” Archbishop Anthony Fisher explained in a post on his Facebook page.

“Whether this vaccine is successful or not, it is important that the government does not create an ethical dilemma for people.”

‘Ethical dilemma’? What ethical dilemma?

For some Christians, the substance of the Archbishops’ letter was well-trodden territory of ethical concern. Some even welcomed it because, in their view, “vaccines contain aborted babies” and Christians must, obviously, oppose abortion.

For others Christians though, this was the first they had heard about an “ethical dilemma” concerning vaccines – aside from the type voiced by opponents of vaccinations (generally known as ‘anti-vaxxers’), which are often at odds with the advice of medical experts.

So, are there substantial ethical concerns Christians should be aware of with a potential COVID vaccine? And if there are, exactly what are they?

Eternity took a long list of questions to Denise Cooper-Clarke and then did a little extra digging of our own. Cooper-Clarke is a graduate of medicine and theology, with a Ph.D in medical ethics. She tutors in medical ethics at the University of Melbourne and is an adjunct lecturer in the subject at Ridley College.

Wait, there’s aborted babies in vaccines?

We started with the big question: Is it true that aborted babies have been used in the creation of the COVID vaccine being developed at Oxford?

“No. The vaccine is developed and grown in fetal cell lines that have been derived from an aborted fetus,” Cooper-Clarke explained.

And a cell line is … ?

“A cell line is a collection of cells that is allowed to grow indefinitely in the laboratory,” she said.

The cell-line (HEK-293) used in the development of the COVID vaccine in Oxford, was originally developed in 1973 using cells grown in tissue culture taken from a human fetus, whose parents are unknown.

Chromosomes in the cell line indicate that the aborted fetus was female.

The cell line was developed from cells from the fetus’ kidney system (where a mix of almost all types of cells present in the body are found) and they were likely neuron cells (ie. from the kidney’s nervous system).

The HEK-293 cell line was cultured by scientist Alex Van der Eb in the early 1970s, at his lab at the University of Leiden, Holland. Another scientist in his lab, Frank Graham – who invented a method for inserting genetic material, such as DNA, into cells – performed this part of the process (called “transformation”).

The name HEK293 was given to the line because it was Graham’s 293rd experiment.

So does that mean a baby was aborted so that it could be used in a cell line to make a vaccine?

“No. I think that it’s really important to make the point that these babies – there’s two babies, we think, from two cell lines which are both used in vaccine development – were aborted back in the late 1960s. They weren’t aborted in order to obtain fetal cells. They were aborted for other reasons,” Cooper-Clarke says.

“Now, if it were the case that all vaccines – or even some vaccines – relied on a continuous supply of aborted fetuses, or if it were the case that some abortions were taking place in order to obtain fetal cells for vaccine, that would be a really different situation.”

How is this different – ethically speaking – to using tissue from a deceased person? Is it just that abortion is a ‘hot button’ topic?

“Well, certainly abortion is a ‘hot button’ topic, but it is somewhere similar to using tissue or material derived from tissue from a dead person …” Cooper-Clarke begins.

“But in that case, you would expect that person had given their consent for the tissue to be used, whereas that’s not the case with an abortion. Obviously the fetus can’t give consent,” she explains.

“I would also think it’s unlikely that the mother gave consent [for the fetus’ tissue to be used] in these cases either. We’re talking about back in the 1960s. Presumably they didn’t ask the mother whether she consented to the fetal material being used in this way,” she adds.

So there must be some regulation around that nowadays, presumably?

“Yes. The NH and MRC [National Health and Medical Research Council] have guidelines for the use of fetal tissue,” she says.

We also found AstraZeneca’s guidelines and this article, that explains some of the requirements around fetal tissue being donated to medical science in the United States now.

If the ethical dilemma isn’t that new babies will be aborted, exactly what is it?

Is the core issue here a bit like investing money gained through some kind of immoral act, letting it gain interest for 50-60 years, and then spending the profit?

“Yes, that’s right. So the question is about complicity,” Cooper-Clarke explains.

“Some people would say that just by benefiting from an act which they think is evil – that is, an abortion some time ago – that you are somehow complicit in it.”

“But I don’t think that is the case because I don’t think there’s any way in which using this vaccine now encourages abortion in any way or legitimises it.”

Instead, she explains, something good is able to come from the tragedy.

But Cooper-Clarke says there are some ethical concerns she shares about vaccines in general, not just the ones derived from fetal cell lines. In particular, in relation to COVID vaccines, she says the speed of the vaccine’s development means there are “quite legitimate concerns about safety”.

“Quite legitimate,” she stresses,”when normally the process takes several years and we’re talking about possibly 18 months.”

She also notes the ethical questions around the availability of the vaccine once it is developed.

“Will it be available – particularly to the people who need it most?” she asks. “And I’m not talking about the elderly and immunocompromised in Australia. I’m talking about people in countries overseas who probably wouldn’t be able to afford it.”

What about the concern expressed by anti-vaxxers about a small percentage of people experiencing adverse reactions? Is the acceptance of vaccines just a case of taking a utilitarian approach that looks after the majority and leaves the minority to cop the worst?

“Well, that’s one way of putting it,” Cooper-Clarke replies, sounding unimpressed by this attempt at playing devil’s advocate.

“Another way of putting it is, is that everybody takes a very small risk in order to benefit the majority. And of course, vaccines are not compulsory. So everyone makes that choice because that’s part of living in a society.”

Voicing ethical objections to vaccinations developed with fetal cell lines – and the Vatican

This ‘choice’ factor is very important, Cooper-Clarke explains. As is the right to ask questions. She goes on to say she believes the Archbishops’ letter has been misreported in the media.

“One headline I saw said ‘Catholics threatened boycott’ – well that’s not what’s happening,” she says.

“I think that people have got a perfect right to raise a question about the origin of some of these vaccines, and to point out that some people will have a conscientious objection to using them.

“I think they’re right to say that it shouldn’t be mandatory because we should always respect people’s consciences.

“Having said that, the Catholic Church has a well developed position,” she explains, referring to a 2005 statement by the Pontifical Academy for Life, “which is that we should raise the question and we should encourage alternatives. In other words, we should say it would be preferable, if the vaccine that we use was not derived from fetal cell lines …”

“And, everything else being equal, if we had a choice between a vaccine that was derived [from] fetal cell lines and a vaccine that wasn’t – and they were both equally safe and effective, and they were both available at same time –we would choose the one that wasn’t arrived from fetal cell lines.”

“That’s unlikely to be the case,” she qualifies.

“And, in any case, the Catholic Church has already determined that if there is no alternative, it is permissible to use the vaccine derived from fetal cell lines. And we already use some of those vaccines.”

“At the moment, I think the Catholics and some others are raising the question – which is perfectly legitimate to do – to point out some people will have objections and it is therefore preferable, if possible, to have a vaccine that wasn’t derived from fetal cell lines.”

Choosing not to use a COVID vaccine for ethical reasons has some pretty huge implications, right?

“It certainly does. It means they’d have to stop using the rubella vaccine and the chickenpox vaccine,” Cooper-Clarke begins.

“There’s probably a great deal of medical advances that we benefit from today that came from perhaps dubious practices sometime ago, because medicine hasn’t always been as closely scrutinised as it is today,” she explains.

But there is more to the ethical implications than just whether we use other vaccines. And – as is often the case with issues of ethics – it gets complicated.

“I think the other really important point to make is that if your basic objection is to abortion, which would be the underlying reason for rejecting the vaccine, your [underlying] basic objection is about the importance of human life and the sanctity of human life.”

“You might be just saying, ‘Well, I don’t want to have the vaccine and I’m prepared to get sick and die’ – perhaps of COVID – but you’ve got to consider that you also would be putting other people at risk,” she says.

“You might, in fact, end up being responsible for several people’s deaths.

“So, if you say that sanctity of life is important to you, well, then, that would be a strong counter-argument.”

Another implication for those who object to being vaccinated with a product developed using fetal cell lines would presumably be that they will also need to reject other medical treatments that have used them in development. This includes treatments for cystic fibrosis.

“Scientific research with fetal tissue is vital for the development of new treatments for many deadly diseases and conditions, such as cystic fibrosis and acute lung injury. There are no alternative research models that can replace all fetal tissue research,” said the American Thoracic Society in a statement released in 2019.

The question then becomes, should one refuse a treatment that doesn’t use cell lines in its development, but did use cell lines in the research process that led to the development of the treatment? For example, in ongoing research into cancer immunotherapy, and Parkinson’s disease, fetal cell lines have been and are still used, but that is not always the case.

At what point is the use of fetal cell lines far enough removed from the treatment, where concerns about complicity become no longer relevant?

Perhaps even more importantly, there’s no evidence – as far as this author can discover – that banning the use of fetal tissue in medical research would lead to fewer babies being aborted. As this article from The Lancet journal succinctly puts it: “The major objection to fetal tissue research is that the source of the fetal tissue is mainly from elective abortions. However, there is no suggestion that the number of abortions will decrease as a result of removing funding for fetal tissue research. Abortion is still legal in all 50 states in the USA and fetal tissue would otherwise be discarded.”

“Fetal tissue research, in fact, holds the potential to save lives through the development of new treatments and vaccines.

“Politicising scientific research in this way means denying hope to millions of patients with life-limiting diseases.”